Question
My wife and I have been trying to conceive for about 6 months now with no success. I wasn’t too alarmed, until my sister-in-law told me my brother was diagnosed with “low mobility male infertility”. I’m not entirely clear what low mobility male infertility is, but it has made me worry if it is hereditary. Is it likely I have this as well? What is involved in investigating it? My brother is not very forthcoming with information about this.

Answer
Male infertility remains somewhat of a taboo topic. This is despite one in 20 men having impaired fertility. Male infertility is almost as common as its female counterpart – roughly a 40/60 split with the fairer of the sexes.

Your brother and his wife have likely seen a fertility specialist. This process is reasonably straightforward. Men are often worked up first, as it is easier to obtain a semen sample than to retrieve an egg. In assessing for male infertility the doctor would have done the following:
· Taken a medical history. The doctor would exclude some causes of male infertility such as chronic disease, illicit and prescribed drug use that may impair fertility, childhood illnesses, or reproductive organ injury.
· Physical examination. This is to exclude physical irregularities in with the male reproductive system, such as irregular testes or signs of hormonal imbalance (eg excessive breast tissue).
· Reproductive and sexual history. This includes information about the mode and timing of intercourse, excluding any spermicidal agents, history of previously fathering children, and timing of puberty.
· Semen analysis. This may involve a series of semen samples, to account for differences in sample quality due to factors such as timing and temperature of the sample.

Your brother’s diagnosis of low mobility male infertility would have been the result of multiple semen samples demonstrating slow or low mobility or motility sperm. This is not the only problem with sperm that can cause male infertility. In other men the cause may be a low sperm count (the most severe is complete absence of any sperm), or abnormally shaped sperm that lack the ability to penetrate an egg.

Low mobility or motility sperm may fail due to a defective tail (flagellum). Like a tadpole, sperm with short slow, or abnormally formed tails are unlikely to progress through the female reproductive tract.

The good news is male infertility is very treatable. This is especially true of low mobility male infertility, as the sperm is usually capable of fertilizing an egg with in vitro assistance. A technique called intracytoplasmic sperm injection (ICSI) may be recommended for your brother. ICSI requires an egg to be collected from the female and injected using a hollow needle with a single sperm. After fertilization has been confirmed, the embryo is then transferred back into the uterus.

There can be a hereditary component to male infertility in some cases. A small percentage of men have a Y chromosomal abnormality that lead to their fertility problems. Regardless, it is premature to assume that you are afflicted with your brothers’ low mobility infertility problems. Infertility can only be diagnosed in the absence of conception after one year of unprotected intercourse. Keep trying. You may conceive in the next six months. Don’t give up if this doesn’t happen, but do consider making an appointment with your local doctor with your partner to discuss the issue.